Sigmoid colon duplication seen as a rare cause of ileus in adult: case report

Abstract

Intestinal duplications are congenital anomalies usually seen in infancy. Since it is congenital, they often become symptomatic in childhood. Usually diagnosed by adulthood. Those seen in childhood are mostly seen in the part from the oral cavity to the middle of the transverse colon, which is defined as the foregut and midgut embryologically. In our case report, we presented a female patient who was diagnosed both in adulthood and presented with ileus caused by duplication in the sigmoid colon. A 24-year-old female patient was admitted with the complaints of intermittent constipation and inability to pass gas and stool for 3 days. It was thought that the pathology observed in the sigmoid colon in the abdominal CT with contrast was due to torsion. Urgent surgery was decided for the patient. During the operation, it was observed that there was duplication in the sigmoid colon and torsion developed due to this. The patient underwent anterior resection and end-to-end anastomosis. She was discharged with surgical recovery in the postoperative period. Intestinal duplications are congenital anomalies that are usually seen in infancy. However, although rarely, it can be detected in adulthood, as in the patient we presented. Duplication anomalies should be kept in mind in the differential diagnosis of patients with chronic constipation and abdominal pain.

Keywords

• Sigmoid colon
• duplication
• ileus

References

1. Polydorides AD. Colon: colonic duplications, cysts, and congenital diverticula. In: Greenson JK, editor. Diagnostic pathology: gastrointestinal. 3rd ed. London: Elsevier Health Sciences; 2019. p. 364-5. Section 5.
2. Mourra N, Chafai N, Bessoud B, Reveri V, Werbrouck A, Tiret E. Colorectal duplication in adults: report of seven cases and review of the literature. J Clin Pathol 2010; 63: 1080-3.
3. Wu X, Xu X, Zheng C, Li B. Tubular colonic duplication in an adult: case report and brief literature review. J Int Med Res 2018; 46: 2970-5.
4. Heiss K. Intestinal duplications. In: KT Oldham, PM Colombani and RP Foglia (eds). Surgery of infants and children: Scientific principles and Practice. Philadelphia: Lippincott–Raven, 1997, pp.1265-76.
5. Puligandla PS, Nguyen LT, St-Vil D, et al. Gastrointestinal duplications. J Pediatr Surg 2003; 38: 740-4.
6. Holcomb GW 3rd, Gheissari A, O’Neill JA Jr, Shorter NA, Bishop HC. Surgical management of alimentary tract duplications. Ann Surg 1989; 209: 167-74.
7. Kekez T, Augustin G, Hrstic I, et al. Colonic duplication in an adult who presented with chronic constipation attributed to hypothyroidism. World J Gastroenterol 2008; 14: 644-6
8. McPherson AG, Trapnell JE and Airth GR. Duplication of the colon. Br J Surg 1969; 56: 138-42.

9. Kang M, An J, Chung DH, Cho HY. Adenocarcinoma arising in a colonic duplication cyst: a case report and review of the literature. Korean J Pathol 2014; 48: 62-5.